Our Summary

This research paper discusses a technique for improving the healing process after rotator cuff surgery, which involves repairing the muscles and tendons in the shoulder. Currently, no studies have successfully shown the consistent regeneration of the connection between the tendon and bone (the “enthesis”). However, the use of bone marrow from the large bump on the upper arm bone (the “greater tuberosity”) has shown promise in improving healing. The healing-enhancing substance made from the bone marrow, humorously named the “crimson duvet” or blanket, is both easy to obtain and inexpensive.

The paper suggests that this technique should be used more often in patients undergoing rotator cuff repair. Ultimately, the goal is to improve the healing of the tendon-to-bone connection through the use of a support structure, cells, and growth factors - substances that promote cell growth. The paper concludes by suggesting that the use of mesenchymal stem cells (a type of basic cell that can turn into different types of cells) and growth factors from the greater tuberosity could be a simple yet effective way to stimulate healing. Future advances in this area are expected.

FAQs

  1. What is the significance of the regeneration of the anatomic enthesis after rotator cuff repair?
  2. How does the use of bone marrow vents in the greater tuberosity improve healing after rotator cuff repair?
  3. What is the potential role of mesenchymal stem cells and growth factors in enhancing tendon-to-bone healing?

Doctor’s Tip

A doctor might advise a patient undergoing tendon repair surgery to follow a structured rehabilitation program to help promote healing and prevent re-injury. This may include exercises to improve range of motion, strength, and flexibility, as well as guidance on proper body mechanics and technique to avoid putting excessive strain on the repaired tendon. Additionally, maintaining a healthy diet, staying hydrated, and getting enough rest are important factors in supporting the healing process. It is also important for the patient to communicate any pain or discomfort to their healthcare provider so that adjustments can be made to their treatment plan as needed.

Suitable For

Patients who are recommended tendon repair typically include those with acute or chronic tendon injuries, such as rotator cuff tears, Achilles tendon ruptures, tennis elbow, and patellar tendon tears. These injuries can result from sports-related activities, repetitive strain, trauma, or degenerative conditions. Patients who have failed conservative treatment or have significant functional limitations due to their tendon injury may be candidates for tendon repair surgery. Additionally, patients who are relatively young and active, have good overall health, and are motivated to participate in postoperative rehabilitation are also good candidates for tendon repair.

Timeline

Before tendon repair:

  1. Patient experiences pain, weakness, and limited range of motion in the affected joint.
  2. Patient undergoes imaging tests such as MRI to confirm the diagnosis of tendon injury.
  3. Orthopedic surgeon consults with the patient to discuss treatment options, including tendon repair surgery.

After tendon repair:

  1. Patient undergoes tendon repair surgery, which may involve arthroscopic or open surgery techniques.
  2. Patient may experience post-operative pain and swelling, and will be prescribed pain medication and physical therapy to aid in recovery.
  3. Over the next several weeks to months, patient follows a rehabilitation program to gradually strengthen the repaired tendon and improve range of motion.
  4. Patient slowly resumes normal activities and sports, under the guidance of their healthcare provider, to prevent re-injury.
  5. Patient continues to follow-up with their healthcare provider for monitoring and adjustments to their rehabilitation program as needed.

What to Ask Your Doctor

  1. What is the likelihood of successful tendon repair in my specific case?
  2. What are the potential risks and complications associated with tendon repair surgery?
  3. What is the expected recovery time and rehabilitation process after tendon repair surgery?
  4. Are there any alternative treatments or therapies that could be considered instead of surgery?
  5. How long will it take for me to regain full strength and range of motion in the repaired tendon?
  6. Will I need physical therapy after surgery, and if so, for how long?
  7. What can I do to optimize the healing and recovery process after tendon repair surgery?
  8. Are there any specific lifestyle changes or modifications that I should make to prevent re-injury to the repaired tendon?
  9. What is the long-term prognosis for my tendon after repair surgery?
  10. Are there any research studies or new technologies that could potentially improve the outcomes of tendon repair surgery in the future?

Reference

Authors: Ciccone W 2nd. Journal: Arthroscopy. 2020 Mar;36(3):638-639. doi: 10.1016/j.arthro.2019.10.040. PMID: 32139045